[Heart failure and cachexia].
Cachexia is related to a malnutrition state related to hypercatabolism. Initially described in cancer, it is also related to several chronic diseases including heart failure. Defined by an unintentional weight loss exceeding 7.5% of body mass during more than 6 months, it is presented by the association of nutritional deficiencies, digestive and/or urinary losses as well as metabolic abnormalities causing fat and lean mass loss and is associated to a poor prognosis. The pathophysiology of cachexia and heart failure presented some similarities associating especially neuro-hormonal activation, a cortisol/DHEA ratio imbalance, as well as pro-inflammatory cytokines activation. Currently the treatment of cachexia is mainly preventive, based on ACE-inhibitors and beta-blockers therapy and physical reconditioning. The benefits of hormonal and nutritional substitutes remains to be evidenced.
Tabet
J Y
JY
Centre de réadaption cardiaque des Grands Près 27, rue Sainte-Christine, Villeneuve-Saint-Denis. jtabet@free.fr
Meurin
P
P
Ben Driss
A
A
Logeart
D
D
Héliès-Toussaint
C
C
Tartière
J M
JM
Cohen-Solal
A
A
Grynberg
A
A
Bourdel-Marchasson
I
I
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002100:Cachexia / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D016207:Cytokines / Q000502:physiology; D006333:Heart Failure / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D008991:Monitoring, Physiologic; D009748:Nutrition Disorders / Q000209:etiology; D012084:Renin-Angiotensin System / Q000502:physiology; D015431:Weight Loss
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D016207:Cytokines